Considerable variability in the efficacy of 8% capsaicin topical patches in the treatment of chronic pruritus in 3 patients with notalgia paresthetica

Notalgia paresthetica (NP) is a focal neuropathic itch con- dition manifesting in intense chronic or recurrent episodic itch in a hyperpigmented, macular, uni- or bilateral skin area located below and/or medially to the scapulae. Achieving satisfactory relieve in NP patients is challenging. In this case-series three female NP patients were treated with 8% capsaicin patches following a spatial quantification of their alloknetic area with a von Frey filament. The use of a von Frey filament in order to delimit the precise area of itch sensitiza- tion and thus patch application, proved clinically feasible. Although 8% topical capsaicin relieved itch in all three pa- tients, the duration of the effectiveness varied greatly from only 3 days to >2 months. The treatment was well tolerated in the patients and there appear to be no significant hin- drances to applying this treatment with NP as an indication, although it may only exhibit satisfactory effectiveness in cer- tain patients. Placebo-controlled double-blinded trials are needed to confirm the effectiveness of the treatment and as- sess predictive parameters of the treatment outcome